J Korean Soc Magn Reson Med.  2011 Dec;15(3):226-233. 10.13104/jksmrm.2011.15.3.226.

Focal Liver Lesion Detection in Gadoxetic Acid-enhanced Liver MRI: Effects of Scan Delay, Hepatic Function, and Magnetic Field Strength

• Kim HS
• Kim MJ
• Chung JJ
• Lim JS
• Chung YE
• Park MS
• Kim KW

• KMID: 2000051
• DOI: http://doi.org/10.13104/jksmrm.2011.15.3.226

Abstract

PURPOSE
To determine the effects of scan delay, hepatic function, and magnetic field strength on the performance of gadoxetic acid enhanced magnetic resonance imaging.
MATERIALS AND METHODS
Gadoxetic acid enhanced MRI conducted in 72 patients with 10 minutes and 20 minutes delay were reviewed retrospectively. For quantitative analysis, liver-to-lesion signal difference ratio (SDR) was measured and compared according to scan delay time, hepatic function and magnetic field strength. For qualitative analysis, two board-certificated radiologists reviewed 10-minute delay and 20-minute delay images. The sensitivity and specificity of each reader was compared.
RESULTS
The SDR of 20-minute images in non-cirrhotic patients was significantly higher (p < 0.01) than that of 10-minute delay images. However, in cirrhotic patients, it was comparable (p > 0.05) to 10-min delay images. In comparisons according to the magnetic strength, there was no significant difference between 1.5-T and 3.0-T systems. Comparisons of ROC curves showed no statistically significant differences in sensitivity and specificity between 10-minute and 20-minute delay images.
CONCLUSION
An increase in the liver-to-lesion signal difference ratio was dependent on the patients' hepatic function but not dependent on the magnetic strength. There was no significant difference in sensitivity or specificity between the 10-minute and 20-minute delay images.

Keyword

Magnetic resonace imaging (MRI); Liver; Gadoxetic acid; GD-EOB-DTPA

MeSH Terms

Gadolinium DTPA
Humans
Liver
Magnetic Fields
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Gadolinium DTPA

Figure

• 

  Fig. 1 An example of the ROI measurement 1) Liver: ROI on the right lobe posterior segment with minimum area of 100 mm2 2) Lesion: minimum ROI area of 50 mm2, avoiding necrotic areas 3) Background noise signal: ROI on right anterior quadrant in oval shape with minimum ROI of 400 mm2 4) Spleen: minimum ROI area of 200 mm2

• 

  Fig. 2 ROC curve of Reader 1 There is no significant difference in sensitivity and specificity between 10-minute and 20-minute delay images (p = 0.117).

• 

  Fig. 3 ROC curve of Reader 2 There is no significant difference in sensitivity and specificity between 10-minute and 20-minute delay images (p = 0.936).

• 

  Fig. 4 Liver-to-Lesion Signal Difference Ratio (SDR): cirrhosis vs. non-cirrhosis Shown is a summary plot based on the median, quartiles, and extreme values. The box represents the interquartile range which contains 50% of all values. The whiskers extend from the box to the highest and lowest values, excluding outliers. A line across the box indicates the median. The SDRs of 20-min images are significantly higher than those of 10-min images in non-cirrhotic patients, but the difference is not significant in cirrhotic patients. There is no significant difference between non-cirrhotic and cirrhotic patients for each value. The mean SDRs for 10- and 20-min delay images are significantly higher compared to those of precontrast images in both non-cirrhotic and cirrhotic patients.

• 

  Fig. 5 Liver-to-Lesion Signal Difference Ratio (SDR): 1.5-T vs. 3.0-T There was a significant difference in all comparisons of SDRs of precontrast, 10-min, and 20-min delay images from both systems. However, there was no significant difference between the 1.5-T and 3-T systems for each variable.

• 

  Fig. 6 A 77-year-old male with hepatic dysfunction The liver shows features of advanced cirrhosis including a nodular liver surface and right lobe atrophy. The patient was diagnosed with hepatocellular carcinoma (white arrows). There was no definite increase in the liver parenchymal enhancement and the SDR measured was 0.43 on a 10-minute delay image (a) and 0.49 on the 20-minute delay image (b).

• 

  Fig. 7 A 59-year-old female without hepatic dysfunction There is a cyst on liver segment 6 (black arrows). The 20-minute delay image (b) shows increased hepatic parenchymal enhancement compared to the 10-minute delay image (a). SDR was calculated to be 0.57 on the 10-minute delay image and 0.68 on the 20-minute delay image.

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